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1 . E <br /> Distance to Public Sewers 4 0 Connection necessary: Yes Noj <br /> Does existing septic system comply with Ord . #549 : Yes_ No_ <br /> Unknown If no, explain: <br /> Describe septic inst4] lation to 'be installed:- <br /> �RW Ce <br /> Z. WATER SUPPLY <br /> Isw ter supplied by private well : Yes X No Is well proper: <br /> Yes. No State deficiency: <br /> DoeaL existing or porposed use make this well public Water: Yes <br /> No Sample of wall water taken: Yes No Date taken <br /> Results Additional information or comments <br /> 3 . GARBAia.S &-REEF SE <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: 91�Z2 <br /> Potential problem:-- <br /> 4 . <br /> roblem:—_4 . FLY, M0SQULTQ 41 VM^TnR PO'CEUTTAL <br /> State possible vector potentirtl necessary control: <br /> l� <br /> 5 . TOILET/BATH FACILITES <br /> No. & location existing: Additional <br /> facilities needed_____ <br /> 6. PREVTOnSCp tiR TIS HISTnRY <br /> 7 . GENERAL SANTIATT11 <br /> State any problems not previously noted: <br /> 3 . POOPULAT T 014 DE,15T v <br /> Appx . No. People per aq. mi. � <br />